Arthritis of the distal radioulnar joint (DRUJ) between the sigmoid notch of the distal radius and the ulnar head can be caused by traumatic, inflammatory, congenital, and degenerative processes and produce pain and functional limitation. Optimal surgical treatment of chronic DRUJ arthritis and instability remains unresolved in the literature. The current panel of experts will debate indications, considerations, and surgical techniques to manage DRUJ instability and arthritis.